Adolescent Health: Priorities for the Next Millennium

There have been dramatic changes in adolescent health status over the past decade that have resulted from successful interventions. Overall mortality rates are down 14%, and many morbidities have declined. Today we know many of the elements that reduce risk: parental caring and connectedness, parental expectations for school and parent availability all outweigh family structure, ethnicity, and income. Likewise, schools can be extremely protective when young people feel connectedness. Factors associated with successful interventions include: strengthening families; strengthening educational involvement; expanding economic opportunities; and supporting youth development, not just problem reduction. Priorities for the next decade include: establishing resiliency-building interventions; developing positive correlates of negative behaviors; establishing broader multisectorial interdisciplinary teams; and formulating a new, more inclusive framework for adolescent health and development.     

Tube Feeding in Neurologically Disabled Children: Hot Topics and New Directions

Tube feeding is a therapeutic intervention that is aimed at providing nutritional support and is important in the nutritional and gastrointestinal management of children with neurological disability (ND) worldwide. Since the publication of the first European Society of Gastroenterology, Hepatology, and Nutrition (ESPGHAN) consensus paper in 2017, some aspects of tube-feeding modalities have attracted the interest of the scientific community more than others, including the type of enteral formulas, enteral access, and the challenging practice of tube weaning. The purpose of this review was to report on the most recent hot topics and new directions in tube-feeding strategies for children with ND.     

Economic Evaluation of Adolescent Addiction Programs: Methodologic Challenges and Recommendations

This article identifies and describes several methodologic challenges encountered in economic evaluations of substance abuse interventions for adolescents. Topics include study design, the choice of perspective, the estimation of costs and outcomes, and the generalizability of results. Recommendations are offered for confronting these challenges using examples from research on adolescent substance abuse and dependency/addiction.     

青少年性与生殖健康服务面临的新挑战和新任务

改革开放以来,青少年所面临的各种环境发生重大变化,对其性与生殖健康也产生重要影响。本文对青少年性与生殖健康服务的新变化进行回顾总结,在现有的服务体系下探求其所面临的新挑战,以及在此挑战下如何更好地改善中国青少年的性与生殖健康教育和服务。     

Advocacy for public health: a primer

Public health advocacy is the strategic use of news media to advance a public policy initiative, often in the face of opposition.     

Fertility Preservation and Adolescent/Young Adult Cancer Patients: Physician Communication Challenges

PurposeThe doctor–parent–adolescent triad is a unique communication challenge, particularly in the area of fertility preservation for adolescents with cancer. This paper provides a preliminary exploration into the barriers experienced by physicians in discussing cancer related fertility issues with patients aged 12–18.MethodsThis study used a subset of the data from qualitative interviews with pediatric oncologists.ResultsThe majority of physicians agreed that fertility preservation conversations were awkward because of limited options and resources for the technology as well as the existence of a fine line between establishing a sense of trust between doctor and patient, while not excluding parents.ConclusionsHealthcare providers need training on how and when to broach fertility issues with patients, emphasizing open communication and early disclosure.     

Advocacy: the time for involvement is now

The American Hospital Association has targeted 1994 for its national advocacy campaign, which is called "Health Care '94: Shaping Tomorrow Today." Health care educators have an important opportunity to participate in the AHA advocacy efforts and to play a role on the local level, perhaps by assisting their institutional campaigns. In order to be effective, they must be (1) informed about national issues and reform efforts, and (2) committed to participating. This article summarizes actions taken in the first half of 1994 and offers options for educators to consider in expanding their own roles in the advocacy effort.     

Advocacy for Health Equity: A Synthesis Review

Context

Health inequalities are systematic differences in health among social groups that are caused by unequal exposure to—and distributions of—the social determinants of health (SDH). They are persistent between and within countries despite action to reduce them. Advocacy is a means of promoting policies that improve health equity, but the literature on how to do so effectively is dispersed. The aim of this review is to synthesize the evidence in the academic and gray literature and to provide a body of knowledge for advocates to draw on to inform their efforts.

Methods

This article is a systematic review of the academic literature and a fixed-length systematic search of the gray literature. After applying our inclusion criteria, we analyzed our findings according to our predefined dimensions of advocacy for health equity. Last, we synthesized our findings and made a critical appraisal of the literature.

Findings

The policy world is complex, and scientific evidence is unlikely to be conclusive in making decisions. Timely qualitative, interdisciplinary, and mixed-methods research may be valuable in advocacy efforts. The potential impact of evidence can be increased by “packaging” it as part of knowledge transfer and translation. Increased contact between researchers and policymakers could improve the uptake of research in policy processes. Researchers can play a role in advocacy efforts, although health professionals and disadvantaged people, who have direct contact with or experience of hardship, can be particularly persuasive in advocacy efforts. Different types of advocacy messages can accompany evidence, but messages should be tailored to advocacy target. Several barriers hamper advocacy efforts. The most frequently cited in the academic literature are the current political and economic zeitgeist and related public opinion, which tend to blame disadvantaged people for their ill health, even though biomedical approaches to health and political short-termism also act as barriers. These barriers could be tackled through long-term actions to raise public awareness and understanding of the SDH and through training of health professionals in advocacy. Advocates need to take advantage of “windows of opportunity,” which open and close quickly, and demonstrate expertise and credibility.

Conclusions

This article brings together for the first time evidence from the academic and the gray literature and provides a building block for efforts to advocate for health equity. Evidence regarding many of the dimensions is scant, and additional research is merited, particularly concerning the applicability of findings outside the English-speaking world. Advocacy organizations have a central role in advocating for health equity, given the challenges bridging the worlds of civil society, research, and policy.     

Key Foods: Setting Priorities for Nutrient Analyses

The Nutrient Data Laboratory is responsible for developing authoritative nutrient data bases that contain a wide range of food composition values for the United States’ food supply. This requires, in addition to other activities, updating and revising the USDA Nutrient Data Base for Standard Reference, the electronic counterpart to Agriculture Handbook No. 8, and supplying nutrient values for the Nationwide Food Surveys. However, with more than 5,200 food items in the data base and a complete nutrient profile costing approximately $2,000 for one sample, the analysis of every food item for every nutrient to meet user requirements is impossible. Consequently, priorities for analyzing foods and nutrients must be determined. Procedures using food consumption data and nutrient values for developing the Key Foods list are explained. Key Foods have been identified as those food components that contribute up to 80% of any one nutrient. When total nutrient contributions from these 527 Key Foods are aggregated, they account for approximately 90% of the nutrient content of the U.S. diet for the 30 nutrients examined. These Key Foods will form the core of the USDA future nutrient analyses contracts. The list of Key Foods as major food contributors of various nutrients is presented.     

Advocacy, promotion and e-learning: Supercourse for zoonosis

This paper discusses the history of emerging infectious diseases, risk communication and perception, and the Supercourse lectures as means to strengthen the concepts and definition of risk management and global governance of zoonosis. The paper begins by outlining some of the key themes and issues in infectious diseases, highlighting the way which historical analysis challenges ideas of the ‘newness’ of some of these developments. It then discusses the role of risk communication to public accountability. The bulk of the paper presents an overview of developments of the Internet-based learning system through the Supercourse lectures that may prove to be a strong arm for the promotion of the latest medical information particularly to developing countries.     

巨大儿与13～18岁青少年肥胖的关系

目的探讨出生体重4000g以上与青少年体质量指数（BMI）及腰围的关系,为探讨出生体重与青少年BMI及腰围的相关性提供参考。方法共抽取出生体重在2500g以上的13～18岁青少年3458人,测量身高、体重、腰围。根据出生体重分为巨大儿组（n=514）和正常出生体重组（n=2944）。结果巨大儿组身高、体重、BMI及腰围均明显高于正常出生体重组（P值均〈0.01）。巨大儿组超重、肥胖检出率分别为15.2%和10.5%,正常出生体重组分别为11.4%和6.5%。校正年龄和性别后,非条件Logistic回归显示,巨大儿组超重和肥胖的危险性分别是正常出生体重组的1.404和1.552倍。以腰围为应变量进行多元线性回归分析显示,性别、年龄、出生体重为腰围的独立危险因素。结论巨大儿组青少年BMI和腰围均存在异常。肥胖的预防应该从胎儿期抓起。